Duerson didn’t have to die to have impact

Why was he — one of the smartest and most successful football players of the 1980s — struggling with memory loss at age 50? What was causing blurred vision and excruciating headaches? Were his personal and financial difficulties connected to brain damage suffered in an 11-year pro career?

Duerson will never know. He killed himself in February. A suicide note asked that his brain be donated to researchers studying the impact of concussions and similar head trauma on deceased players.

Duerson’s gesture should help doctors better understand the mental health difficulties that are plaguing some NFL retirees. Duerson ultimately might be remembered as much for his role in remedying these problems as he is for being a popular two-time Super Bowl winner with the Chicago Bears and New York Giants.

Duerson, though, didn’t have to die to help others.

So says Eric Hipple, an NFL contemporary who later became an expert on depression. Hipple believes Duerson might have overcome his suicidal bent had he sought professional treatment. Duerson then could have created a living legacy as an advocate for peers struggling with the same issues.

“This is such a terrible thing to have happen,” said Hipple, a former Detroit Lions quarterback who is an outreach coordinator for the University of Michigan’s depression center. “Sometimes when people experience things like he was, they start to think, ‘It must be my brain. I’m going to sacrifice myself so others can feel better and get cured.’

“That’s really sad. He could have said, ‘Let’s take another look at this. It might be depression. They might be able to treat that.’ He could have been directly helped, I truly believe, and gotten into enjoying life again.”

Hipple knows firsthand about depression and suicide. He battled the former as well as substance abuse once his nine-year NFL career ended after the 1989 season. Hipple’s teenage son, Jeff, then committed suicide in 2000 after silently suffering from the same depression issues his father was facing.

Hipple has since dedicated himself to raising depression awareness among affected NFL retirees, some of whom have the misguided belief that admitting mental illness is emasculating. Although understanding and acceptance has improved in recent years, 54 percent of those surveyed in a 2004 National Mental Health Association study considered depression a sign of “personal weakness.”

Former defensive back Andre Waters, defensive end Shane Dronett and offensive lineman Terry Long are other longtime players who were ruled to have committed suicide within the past five years.

“A lot has to do with the mind-set that you grow up with in the football culture,” Hipple said. “That’s not showing you’re hurt or talking about any weakness because you want to be on the field. You want to be one of the people your teammates look up to. You don’t want to be singled out.”

Duerson’s troubles are very likely to have stemmed at least partially from football-related brain damage. A posthumous Boston University medical study revealed that the four-time Pro Bowl safety was suffering from advanced chronic traumatic encephalopathy (CTE), a degenerative and incurable disease also discovered in more than 20 other NFL retirees whose brains were donated for research. CTE can cause dementia, memory loss and depression.

Duerson had filed for personal bankruptcy last September after his once-prosperous food-distribution business went into receivership. Duerson also had resigned from Notre Dame’s board of trustees in 2005 after pleading guilty to misdemeanor domestic violence against his wife. The couple divorced last year, with Alicia Duerson seeking $70,000 through a bankruptcy court filing that claimed he was hiding assets.

Alicia Duerson told USA Today that Boston University researchers noticed her ex-husband’s brain was small for a man of his size. “His brain had started dying 10 years ago,” she said.

Duerson is believed to have suffered multiple concussions during an era when diagnosis and treatment weren’t handled with the same care or regard as it is in today’s NFL.

“My father was a man of many accomplishments,” Duerson’s son, Tregg, said at a May news conference announcing the CTE finding. “With these accomplishments came many battles.”

Duerson’s role as a trustee for the retirement plan run jointly by the NFL and NFL Players Association has come under heavy scrutiny by critics who question whether he was competent to serve. One of them is Andrew Stewart. The former NFL defensive end filed a lawsuit against the Bert Bell/Pete Rozelle NFL Retirement Plan after his appeal for an increased disability pension was unanimously denied by the trustees.

A pretrial hearing for Stewart’s lawsuit is scheduled for Sept. 8 in a US district court in Maryland.

"I didn’t know Mr. Duerson and I was sad to hear about his death,” Stewart told FOXSports.com. “But when I started hearing about things that had happened in the past with his wife, his businesses and everything else, I was really shocked. I’m surprised that someone in his position and diminished capacity was still voting on these (retirement plan) issues.”

But for some who interacted with Duerson professionally in his final months, there was never a noticeable change in his demeanor or acumen.

“I’ve asked people who had spoken and met with him, and no one can say, ‘We really saw this coming down the road,’ ” said 10-year NFL veteran Nolan Harrison, who now works with retirees as a senior NFLPA executive. “I know former players who you can see slowly start to degrade mentally. You can see concussions have taken a toll on them with their speech and things like that. With Dave, you just didn’t sense that.”

That same sentiment was echoed by Belinda Lerner, executive director of the NFL Player Care Foundation. Lerner told FOXSports.com that Duerson had “his complete faculties working” and “contributed to the conversation” at the last trustees meeting both attended six months before his death.

“He seemed fine the last time I saw him,” Lerner said. “He was with his fiancée. To me, someone who is going to get married is someone who is feeling hopeful for the future.”

Hipple said it isn’t uncommon for someone suffering from depression to hide symptoms from coworkers and even those closest to them.

“People try to put on their best face because they don’t want to feel like a burden,” Hipple said. “Unless you’re with someone 24/7, you’re just seeing pieces.”

A 2008 University of Michigan study revealed that former NFL players have a higher depression rate than the normal populace. About 25 percent of the 1,063 retirees surveyed were either diagnosed with depression or had experienced a major episode in their lifetime. The US national average for depressive disorders among adults 18 and older was 9.5 percent in a 2008 survey by the National Institute for Mental Health.

Like other NFL retirees, Duerson had the chance to receive treatment for depression through plans offered by the league and NFLPA. The latter has reformed its partnership with the University of Michigan to sponsor a consultation program. Ex-players are evaluated monthly for a year and receive treatment from both university-affiliated doctors and their own personal health practitioners.

“Our goal after 12 months or hopefully sooner is to have (patients) symptom-free completely,” Hipple said.

The NFLPA and NFL also provide services designed to help retirees switch to another career. At the NFL Career Transition seminars, Lerner said, a counselor attends who is looking for “red flags” among ex-players who may unknowingly be displaying signs of depression. Those retirees are then discreetly approached and offered the chance for diagnosis. Lerner said this happened with “a few” of the 80 players who attended a program at Georgia Tech earlier this year.

That Duerson already had chosen a post-NFL career tract while playing — he earned a master’s degree in business from Harvard en route to becoming a McDonald’s franchisee — allowed him to make a successful transition upon retirement in 1994. Those who haven’t planned or settled upon a new livelihood can begin to feel despair, especially without the group support provided in the football world.

“When your time in the NFL is over with, you’re ostracized,” Hipple said. “When you’re cut and walk out that door, you can’t come back in. Stress then starts from that loss, the loss of income and friendships. And then it becomes, ‘What are you going to do now?’ ”

Include the possibility of brain damage from football and the chances for depression and substance abuse rise.

“Guys leaving the league can suffer from things like that,” Harrison said. “The stats show that alcoholism, bankruptcy and divorce rates are higher. A lot of these things anecdotally can point to depression being one of the main causes.

“The transition to life outside the game takes a toll on guys mentally. You’ve then got the whole aspect of brain damage from multiple hits. I think you’re going to continue to see increases in incidents of this type and more and more problems.”

Ken Ruettgers was one of the first to publicly admit to post-football depression. While playing tackle in Green Bay for 12 seasons (1985-96), Ruettgers had diligently prepared to make a smooth transition to the “real world.” He spent offseasons as a real-estate appraiser, wrote a book on fathers being role models for their children and earned a master’s degree.

But after retiring at age 34, Ruettgers experienced many of the same mental ailments that have affected his peers. Ruettgers lost passion to pursue a new livelihood. He became irritable and distant.

“At the height of my short bout with depression there were probably three or four days in a row where I never took a shower or even got out of bed before 10 a.m.,” Ruettgers said. “I’d stay in my sweats all day.”

The situation became so alarming that Ruettgers’ wife worried he was headed down the same path Duerson traveled.

“I still remember the day she called her dad on the phone,” Ruettgers said. “She didn’t want to bring up with me how fearful she was that I was so depressed I might commit suicide. I never had a thought of suicide — at least a serious thought of it.

“In talking to hundreds of other players over the last 15 years, this is a pretty typical thought: If I were to die by running my car off the cliff, would it really matter to anybody? There’s a lot wrapped into that statement. There’s a lot of arrogance and pride, but I also think it’s an indication of a lack of purpose in life, as well as hope to some degree.”

Ruettgers rebounded and made depression awareness for former NFL players his career focus. He started a nonprofit group with a website (www.gamesover.org) offering advice. Ruettgers also earned a doctorate in sociology that has led to a teaching position at Central Oregon Community College.

Ruettgers and Hipple were both hard-hit personally by Duerson’s suicide through their shared experiences. All three not only battled depression but played against each other frequently in NFC Central divisional matchups.

“There were a lot of issues Dave was trying to contend with in his life,” Ruettgers said. “Just reading about them were enough to depress a guy.”

Hipple hopes Duerson’s death motivates those who might be suffering from depression to seek treatment in lieu of suicide. Hipple also believes the NFL and its teams should take a page from the US armed forces when it comes to the handling of former players.

Inspired by his work with renowned military psychologist Bryce LeFever, Hipple suggested that NFL retirees become “debriefed” after their football careers end like soldiers returning from missions. Pride from having played in the NFL also should be championed by the league and its teams, much as the military does with its former servicemen, to help reduce the sting of being released or forced into retirement.

“The joke is that the NFL stands for ‘Not For Long,’ ” Hipple said. “Wouldn’t it be cool if it became, ‘Now For Life?’ ”